Equitable implementation of S.A.F.E. Firearm: A multi-method pilot study.
Equitable implementation of S.A.F.E. Firearm: A multi-method pilot study.
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公平实施 S.A.F.E.枪支：多方法试点研究。
DOI：
10.1016/j.ypmed.2022.107281
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发表时间：
2022-12
影响因子：
5.1
通讯作者：
Beidas, Rinad S.
中科院分区：
文献类型：
--
作者：
Hoskins, Katelin;Linn, Kristin A.;Ahmedani, Brian K.;Boggs, Jennifer M.;Johnson, Christina;Heintz, Jonathan;Marcus, Steven C.;Kaminer, Isabelle;Zabel, Celeste;Wright, Leslie;Quintana, LeeAnn M.;Buttenheim, Alison M.;Daley, Matthew F.;Elias, Marisa E.;Jager-Hyman, Shari;Lieberman, Adina;Lyons, Jason;Maye, Melissa;McArdle, Bridget;Ritzwoller, Debra P.;Small, Dylan S.;Westphal, Joslyn;Wolk, Courtney Benjamin;Zhang, Shiling;Shelton, Rachel C.;Beidas, Rinad S.
注意保健公平性对于实施枪支安全工作至关重要。我们提出了我们的运作，以公平为导向的建议，准备推出一个混合的有效性，实施试验，重点是枪支安全促进儿科初级保健作为一个普遍的自杀预防策略。在我们流程的第1步，与利益相关者的试验前接触和文献综述提醒我们，枪支安全计划的实施可能因患者的医疗复杂性、种族和民族而异。在步骤2中，我们选择了健康公平实施框架，以告知我们对背景决定因素的理解（即，障碍和促进者）。在第3步中，我们利用2个卫生系统站点的5个儿科初级保健诊所的实施试点来研究不公平的信号。纳入了694名患者和47名临床医生的合格健康儿童访视。我们的研究结果表明，医疗复杂性与项目交付无关。我们确实看到了种族和族裔不平等的潜在信号，但必须谨慎解读。虽然我们最初没有计划检查性别差异，但我们发现临床医生可能更有可能向男性而不是女性的父母提供该计划。与临床医生的七次定性访谈提供了额外的背景。在第4步中，我们询问了股权考虑因素（例如，这些不平等现象为何存在以及如何存在）。在第5步中，我们将制定一项计划，以监测和缓解完全把握度试验中与人种、种族和性别相关的潜在不平等。我们的过程强调，前瞻性，严格的，探索性的工作是至关重要的公平知情的实施试验。
Attention to health equity is critical in the implementation of firearm safety efforts. We present our operationalization of equity-oriented recommendations in preparation for launch of a hybrid effectiveness-implementation trial focused on firearm safety promotion in pediatric primary care as a universal suicide prevention strategy. In Step 1 of our process, pre-trial engagement with stakeholders and literature review alerted us that delivery of a firearm safety program may vary by patients’ medical complexity, race, and ethnicity. In Step 2, we selected the Health Equity Implementation Framework to inform our understanding of contextual determinants (i.e., barriers and facilitators). In Step 3, we leveraged an implementation pilot across 5 pediatric primary care clinics in 2 health system sites to study signals of inequities. Eligible well-child visits for 694 patients and 47 clinicians were included. Our results suggested that medical complexity was not associated with program delivery. We did see potential signals of inequities by race and ethnicity but must interpret with caution. Though we did not initially plan to examine differences by sex, we discovered that clinicians may be more likely to deliver the program to parents of males than females. Seven qualitative interviews with clinicians provided additional context. In Step 4, we interrogated equity considerations (e.g., why and how do these inequities exist). In Step 5, we will develop a plan to monitor and mitigate potential inequities related to race, ethnicity, and sex in the fully powered trial. Our process highlights that prospective, rigorous, exploratory work is vital for equity-informed implementation trials.
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DOI：
10.1186/s13012-021-01097-0
发表时间：
2021-03-19
期刊：
Implementation science : IS
影响因子：
--
作者：
Brownson RC;Kumanyika SK;Kreuter MW;Haire-Joshu D
通讯作者：
Haire-Joshu D
影响因子：
0.8
作者：
BEEBE, J
通讯作者：
BEEBE, J
影响因子：
--
作者：
Hambidge, Simon J.;Emsermann, Caroline Bublitz;Steiner, John F.
通讯作者：
Steiner, John F.
影响因子：
7.2
作者：
Gale, Randall C.;Wu, Justina;Midboe, Amanda M.
通讯作者：
Midboe, Amanda M.
DOI：
10.1186/s13012-021-01154-8
发表时间：
2021-09-22
期刊：
Implementation science : IS
影响因子：
--
作者：
Beidas RS;Ahmedani BK;Linn KA;Marcus SC;Johnson C;Maye M;Westphal J;Wright L;Beck AL;Buttenheim AM;Daley MF;Davis M;Elias ME;Jager-Hyman S;Hoskins K;Lieberman A;McArdle B;Ritzwoller DP;Small DS;Wolk CB;Williams NJ;Boggs JM
通讯作者：
Boggs JM